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ICD-10 Guide
ICD-10 CodesG81.00

G81.00

Billable

Flaccid hemiplegia affecting unspecified side

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 G81.00 is a billable code used to indicate a diagnosis of flaccid hemiplegia affecting unspecified side.

Key Diagnostic Point:

Flaccid hemiplegia is a condition characterized by weakness or paralysis on one side of the body, resulting from damage to the motor pathways in the brain. This specific code, G81.00, indicates that the hemiplegia is flaccid and affects an unspecified side, meaning that the clinician has not specified whether the left or right side is affected. Flaccid hemiplegia is often associated with conditions such as cerebral palsy, stroke, or traumatic brain injury. In cerebral palsy, for instance, it may result from a non-progressive brain injury that occurs during fetal development, birth, or shortly after. Patients may experience significant mobility impairments, requiring assistance with daily activities and rehabilitation services. The lack of muscle tone in the affected limbs can lead to complications such as joint contractures and pressure sores. Accurate coding is essential for appropriate treatment planning and reimbursement, as well as for tracking the prevalence of such conditions in the population.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified side may lead to ambiguity in clinical documentation.
  • Differentiating between flaccid and spastic hemiplegia requires careful assessment.
  • Potential overlap with other neurological conditions complicates coding.
  • Variability in clinical presentation necessitates thorough documentation.

Audit Risk Factors

  • Inadequate documentation of the specific side affected.
  • Failure to document the underlying cause of hemiplegia.
  • Misclassification of hemiplegia type (flaccid vs. spastic).
  • Lack of supporting evidence for mobility impairments.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, including muscle tone assessment and functional limitations.

Common Clinical Scenarios

Patients presenting with sudden onset of weakness, post-stroke rehabilitation, or developmental delays in children.

Billing Considerations

Ensure clarity in documentation regarding the type of hemiplegia and any associated neurological deficits.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of mobility, functional independence, and rehabilitation goals.

Common Clinical Scenarios

Rehabilitation following stroke, traumatic brain injury, or cerebral palsy management.

Billing Considerations

Document the impact of hemiplegia on daily activities and the need for assistive devices.

Coding Guidelines

Inclusion Criteria

Use G81.00 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the code is supported by clinical documentation
  • Include details about the onset, duration, and any associated conditions

Exclusion Criteria

Do NOT use G81.00 When
  • Exclude conditions that are not directly related to hemiplegia

Related ICD-10 Codes

Related CPT Codes

97110CPT Code

Therapeutic exercises

Clinical Scenario

Used in rehabilitation for patients with hemiplegia to improve strength and mobility.

Documentation Requirements

Document the specific exercises performed and the patient's response.

Specialty Considerations

Physical therapy documentation should include goals and progress.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like flaccid hemiplegia, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like flaccid hemiplegia, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between flaccid and spastic hemiplegia?

Flaccid hemiplegia is characterized by reduced muscle tone and weakness, while spastic hemiplegia involves increased muscle tone and stiffness. Accurate documentation is essential to differentiate between the two.